November 1999

Survey This (Part II)

By Michael J. Katin, MD

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The May, 1999, column dealt with the increasing problem with the need for practice survey and accreditation. As mentioned at that time, our research department has obtained a copy of an internal memorandum from one of these agencies, the JACIAWCGPFD (the Joint American Commission for Inspecting Anything We Can Get Paid For Doing) and at risk of litigation, here is the document in its entirety.

To: Survey Team Members, Survey G-BS911

Topic: Evaluation of Final Report

The board of the JACIAWCGPFD has received your report on practice G-BS911 and we appreciate your efforts. As had been discussed with you during your 45-minute training program, your conclusions will be upheld particularly since they will result in practice G-BS911 requiring an interim reinspection in eight weeks. We would therefore want to comment on several points in anticipation of their correction at the time of the reinspection:

1. Our current emphasis on patient privacy was appropriately expressed by the survey team members. We note the comments that although most of the charts seen in that office had removed any reference to the patients' names not only from the covers but also from the dictations, there were still instances in which the therapists referred to patients by their names when treatment was carried out. You appropriately took away points for this, but we remain suspicious of the potential accuracy of the substituted plan to call patients by code names (e.g., "Slick," "E.T.," "Shamu"). This could work as long as the same therapists are there every day and particularly if the code name is descriptive while still remaining politically correct. We think, however, that switching to a numerical system would still be preferable.

2. The board appreciates the astuteness of the survey team in downgrading the facility for the ambiance of the waiting area. We agree that patients can benefit from having distraction by a television set, fish tank, or even an aviary, but it remains somewhat of a stretch to consider a roach motel in that same category.

3. The absence of adequacy of parking was nearly overlooked by the survey team. Presumably this was due to the mistaken assumption that the gentleman who took the vehicle from Dr. Green was from valet parking. It turns out this service is not available at practice G-BS911. Dr. Green informed me following the report that he will be getting his vehicle back from the authorities now that it has been located in New Jersey minus most of its accessories.

4. The survey team appropriately recognized that practice G-BS911 is trying to become more active in community outreach programs but regardless we think that the use of inner-city elementary school students as "junior dosimetrists" may potentially result in inaccuracies.

5. The survey team appropriately credited the practice with supplying an adequate volume of patient information material, although we suggest that relying on photocopies of articles from The National Enquirer may be too limited in perspective.

6. There was a comment that one of the survey team members actually looked at one of the linear accelerators; whereas this probably indicates a desire to be thorough, it reduced the time that should have been spent on assessing the employee anti-smoking program. This person has been informed of this and assures me she will not be distracted in the future.

7. The board agrees totally with the survey team that points should have been deduced for the lack of upgrade of the sprinkler system; we agree that having the senior therapist running through the halls with two Super Soakers does not compensate for this.

8. The board appreciates the survey team's confusion regarding whether there is truly an adequate number of staff employed at practice G-BS911 but we have been assured that it was a mistaken impression that some of them were seen working later that day at the Burger King next door.

9. Finally, the board wishes to remind the survey team that on November 18 you will be reviewed by representatives of the AJICRIO*. Good luck, although we are certain you will do very well. Copies of AJICRIO standards will be crated and delivered to you later this week.

*American Joint Inspection Committee to Review Inspecting Organizations

email: mkatin@radiotherapy.com